Overview
Dialysis is a medical treatment used when the kidneys are no longer able to filter the blood well enough to keep the body in balance. It can help control fluid levels, remove waste products, and correct some chemical imbalances. Dialysis may be started suddenly in an emergency or planned over time for chronic kidney disease.
Who Is Affected
People with advanced kidney failure may need dialysis. This includes people whose kidneys have been damaged over many years by conditions such as diabetes or high blood pressure, as well as people who develop sudden kidney failure from severe illness, injury, infection, or certain medicines. Adults and children can both need dialysis.
Diagnosis and Tests
Healthcare professionals decide whether dialysis is needed by looking at symptoms, medical history, physical examination, and blood and urine test results. Tests often include kidney function measures, electrolyte levels, acid-base balance, and fluid status. Imaging tests and heart monitoring may also be used depending on the situation.
Treatment Categories
The two main forms of dialysis are hemodialysis and peritoneal dialysis. Hemodialysis uses a machine and a filter to clean the blood, usually through a specially prepared blood vessel access. Peritoneal dialysis uses the lining of the abdomen and a cleansing fluid placed into the belly through a catheter. The choice depends on medical needs, daily life, home support, and discussion with the care team.
Living With It
Living with dialysis often involves a regular treatment schedule, frequent medical visits, and ongoing blood tests. Many people also need medicines, treatment for anemia or bone problems, and planning around work, school, travel, and family life. Emotional stress is common, so support from healthcare professionals, family, peers, or counselors can be helpful.
Diet and Lifestyle
People on dialysis often need a kidney-focused eating plan and careful attention to fluid intake, but the details vary from person to person. A kidney dietitian can help with choices about protein, salt, potassium, phosphorus, and fluids. Avoiding tobacco, staying active as able, and taking medicines exactly as directed are also important parts of care.
When to Seek Medical Care
Contact a healthcare professional promptly for fever, chills, new swelling, shortness of breath, vomiting, severe fatigue, chest discomfort, or problems with a dialysis access site such as redness, pain, bleeding, or drainage. Also seek care for missed dialysis sessions, sudden weight gain, confusion, fainting, or signs that treatment is not working as expected. Do not ignore worsening symptoms between scheduled sessions.
When It May Be an Emergency
Emergency care may be needed if a person on dialysis has severe trouble breathing, severe chest pain, heavy bleeding from an access site, seizures, sudden confusion, or becomes hard to wake up. Dangerous changes in potassium, fluid buildup, infection, or very high toxin levels can become life-threatening. If these symptoms happen, seek urgent medical help right away.
Questions to Ask a Healthcare Professional
Useful questions include: Why is dialysis needed now, and is it expected to be temporary or long term? Which type of dialysis may fit my health needs and daily life? What warning signs should I watch for at home, and what changes in diet, fluids, travel, work, or activity should I plan for?